Current through December 27, 2024
Section 17b-262-1002 - Billing requirements(a) Each FQHC shall bill for FQHC services per encounter. Claims are limited to one all-inclusive encounter per day to include all services received by a client on the same day unless the client suffers an illness or injury subsequent to the first encounter that requires additional diagnosis or treatment or if the client has different types of visits on the same day such as medical and dental or medical and behavioral health. Medicaid pays for one medical, one dental, and one behavioral health encounter per day.(b) Each FQHC shall submit medical and behavioral health claims on the CMS-1500 utilizing both the encounter code and all applicable HCPCS code(s) on the FQHC fee schedule that identify the services provided.(c) Each FQHC shall submit dental health claims on the original designated American Dental Association Dental Claim form.(d) Each FQHC shall submit claims electronically or on the department's designated form and shall include all information required by the department to process the claim for payment.Conn. Agencies Regs. § 17b-262-1002